Provider Demographics
NPI:1972702363
Name:LIN, DAGMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:DAGMAR
Middle Name:
Last Name:LIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1331 BRICKELL BAY DRIVE, APT 1703
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131
Mailing Address - Country:US
Mailing Address - Phone:305-484-1138
Mailing Address - Fax:
Practice Address - Street 1:1611 SW 12TH AVE, CENTRAL ROOM 455, MICU ADMIN OFFICES
Practice Address - Street 2:JACKSON MEMORIAL HOSPITAL, UNIVERSITY OF MIAMI
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33136
Practice Address - Country:US
Practice Address - Phone:305-585-6664
Practice Address - Fax:305-585-0086
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-16
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI5287207R00000X
FL15871207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine